Exploring the dynamics of social roles in hospital evacuation: Factors, roles and behaviors

As a critical city facility of our society, it is important for hospitals to be resilient against emergencies for a health imperative and economic buoyancy. Understanding the evacuation behaviors of hospital roles and the corresponding influencing factors is essential for the accurate execution of emergency response plans and well-being. Therefore, this study aims to explore the dynamics of social roles in hospital evacuation by understanding the mediation effects of role evolution factors (i.e., responsibility, competence, and expectation of evacuation roles). Questionnaires on hospital roles, role evolution factors, and evacuation behaviors were designed and distributed, with a total of 324 responses from various hospital occupants. The common method variance analysis, internal consistency test, item analysis, and exploratory factor analysis consistently indicated good reliability and validity of the questionnaire. Chain mediation models of three prominent evacuation roles, namely leader, emergency responder, and follower were developed, with the three role evolution factors as mediating variables, evacuation behavior as the dependent variable, and hospital role as the independent variable. Findings indicated significant path effects of hospital roles and role evolutionary factors on leadership, emergency responding, and following behaviors. One-way ANOVA on egocentric behavior and hesitant behavior of hospital roles revealed that patients have a higher propensity for negative behaviors compared with hospital staff. In light of the findings, the subtle relationship between hospital roles, role evolution factors, and evacuation behaviors was revealed. Role-specific leadership training, role-based emergency response management, role-related following behavior guidance, and negative behavior reduction measures were proposed for improving hospital safety.